Monday, May 27, 2013

AUSTIN, TEXAS, May 26, 2013 - The vice chair of the homeland security committee in the Texas House says there is a direct connection between drug cartels and Medicaid fraud being perpetrated along the South Texas border region.

For this and other reasons, state Rep. Allen Fletcher said he offered an amendment to Senate Bill 8 that will allow the Office of Inspector General (OIG) to hire commissioned peace officers for their investigations into Medicaid fraud. Senate Bill 8 is a major piece of legislation dealing with fraud, waste, and abuse in the Medicaid program.

“There is Medicaid fraud all over the state, Dallas, Houston, you name it. The cartels are in Dallas and Houston. But way along the border, and all along the border, McAllen, Brownsville, Cameron County, Hidalgo County, Starr, all those areas, there is huge cartel influence and I assure you that these individuals that are involved in setting up these bogus clinics and hiring these dentists and doctors to file these fraudulent Medicaid claims, it’s cartels,” Fletcher said.

Fletcher is one of just a few retired police officer serving in the Texas House. He investigated white collar crime for Houston Police Department for many years. Fletcher said he spoke to Jack Stick, deputy inspector general for enforcement for the Office of Inspector General Texas Health and Human Services Commission, about carrying an amendment for Stick to allow OIG to have commissioned peace officers working as investigators.

Tuesday, May 14, 2013

Smile Starters, formerly known as Medicaid Dental Centers, first made the news in North Carolina in 2003. 10 years later, little that has changed, other than its name and signage.

Reporter, Diane Wilson, with the ABC affiliate in Raleigh-Durham, NC reports on continued fraudulent diagnosing practices Smile Starters Dental Centers in North Carolina. You can contact ABC’s “Troubleshooters” at troubleshooter@abc11mail.com

Listen for the usual Medicaid dental mill “buzz” words and phrases, such as: “Corporate”,“Chief Dental Officer”, “Do Not Allow Parents Back with the Child” and “Lead Dentist”.

End of EyeWittness ABC Channel 11 Report

However unlikely it is for the North Carolina Dental Board to take action, it is still extremely important a complaint is filed and on record, so to speak. To file a complaint with the North Carolina Dental Board click here.

What they couldn’t tell you in the report:

Smile Starters and the dentists who work there, are very much familiar with the North Carolina Dental Board and visa-versa. With the new regulations in North Carolina on how dentists and management companies operate, maybe the dental board could take a look at Smile Starters and Root Dental Management and expose the truth behind the true ownership of Smile Starters Dental Centers.

Smile Starters Dental Centers have operated under Medicaid Dental Centers (MDC), North Carolina Dental Centers and Smile Starters. As reported above, Dr. Ralph Rivera was Smile Starters Chief Dental Officer under the prior ownership of Dr. Michael A. DeRose and Dr. Letitia L. (Tish) Ballance. Although it would be hard to prove outside a legal setting — where documents would have to be produced — I whole heartedly believe Michael A. DeRose sill owns and controls these dental clinics. Being that Michael A. DeRose has had his license revoked and is also listed on the governments LEIE (List of Excluded Individuals and Entities) list, it would be highly illegal for him to own a dental clinic or received monies from Medicaid or Medicare, directly or indirectly. If he maintains any ownership, it would have to be masked by a few layers of corporations, and the DeRose’s are good at that game, or at least think they are.

“As a mother of two children, I was shocked to learn that in 2010, there were estimated to be over 15,000 Texas children who were given inappropriate dental care, including braces on baby teeth,” said Kolkhorst. “Most of these were Medicaid cases that involved dentists and dental clinics who would not allow parents to observe the dental care given to their children.” Under the bill’s reforms, Texas parents and legal guardians would be given the right to observe most dental services being provided to their children.

Kolkhorst also said her legislation is aimed at cracking down on the millions of dollars in dental and orthodontic Medicaid fraud recently uncovered by both WFAA-TV investigative news reports (in North Texas) and the Texas Attorney General’s office.

He is a fellow of the American College of Dentists and International College of Dentists, as well as a board director of the American Academy of Esthetic Dentistry. In 2011, he was named the Washington Dental Service Foundation Distinguished Professor for Dentistry.

Dr.Davis: We continue to see a disturbing degree of misrepresentations in dental marketing and advertising, in which general dentists attempt to represent themselves as specialists. Sometimes, this is seen with individual practitioners, and sometimes we see these misrepresentations from larger interstate dental providers. We can’t expect the public to have our degree of sophistication and professional knowledge, to read fact from fiction. How can the public best be protected from these unprofessional charlatans?

Dr. Berg: A big part of the answer is for state dental boards to enforce the laws and regulations that are currently on the books concerning the criteria for specialty advertising (namely, that a dentist cannot state or imply specialization absent appropriate training in one of the nine recognized dental specialties). The AAPD provides guidance on advertising to our affiliate (general dentist) members and we have also shared this with state dental boards. We applaud those general dentists who take care of children and do so in accordance with AAPD’s clinical guidelines. For purposes of advertising, the AAPD believes the following terms are acceptable by a general dentist: Family Dentistry, General Dentistry for Children or General Dentistry for Children and Families. However, the AAPD believes the following phrases are confusing to the public and contrary to the membership obligations of the Affiliate category: Child Dentistry, Children’s Dentistry, Dentistry for Children, Dentistry for Kids or Pediatric Dentistry. Affiliate members using such terms are subject to disciplinary action by the AAPD. We are aware that some corporate chains have names that are misleading, and we believe that state dental boards should appropriately regulate such advertising.

Friday, May 03, 2013

Next week, Dentist The Menace, will publish an exclusive interview of Dr. Joel Berg, current president of the AAPD. He will face tough questions relating to mobile dentistry, problems facing recent dental grads, ethical issues of corporate third parties intrusion into the doctor/patient relationship, & the concept of a "Dental Home" for our nation's children.